U.S. patent number 4,832,021 [Application Number 07/115,623] was granted by the patent office on 1989-05-23 for apparatus and method for assembly and disassembly of interchangeable surgical acoustic members.
This patent grant is currently assigned to Cooper LaserSonics, Inc.. Invention is credited to Alan Broadwin, Robert W. Hornlein, Peter Kuhl.
United States Patent |
4,832,021 |
Kuhl , et al. |
May 23, 1989 |
Apparatus and method for assembly and disassembly of
interchangeable surgical acoustic members
Abstract
An apparatus and method for assembly and disassembly of
interchangeable surgical acoustic members includes a fixture for
securing by a key a handpiece to which a tip and/or extender is
attached. A torquing wrench has a tightening head and an
untightening head on the same body, wherein the tightening head
permits torquing of the tip and/or extender to a predetermined
tightening torque in cooperation with a socket having a central
bore therethrough so that the wrench and socket may be slid over an
axially elongated combination and used at a point intermediate
along the length thereof. In use, the handpiece is secured in the
handpiece fixture and receives the tip and/or extender in a
handtightened condition to be torqued to a predetermined limit by
the torquing wrench while secured against rotation in the handpiece
fixture. A table support structure for supporting a handpiece
fixture for an alternative operation is also disclosed. The
components are designed for a ready exchange of acoustic tips prior
to, during, or after surgery in the sterile field with minimum
inconvenience.
Inventors: |
Kuhl; Peter (Jackson Heights,
NY), Broadwin; Alan (Brooklyn, NY), Hornlein; Robert
W. (Stamford, CT) |
Assignee: |
Cooper LaserSonics, Inc. (Santa
Clara, CA)
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Family
ID: |
26813402 |
Appl.
No.: |
07/115,623 |
Filed: |
October 30, 1987 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
Issue Date |
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782306 |
Oct 1, 1985 |
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761495 |
Aug 1, 1985 |
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Current U.S.
Class: |
606/1; 269/287;
81/467; 81/59.1 |
Current CPC
Class: |
A61B
17/22012 (20130101); B25B 11/00 (20130101); B25B
23/0085 (20130101); B25B 23/1427 (20130101) |
Current International
Class: |
A61B
17/22 (20060101); B25B 23/142 (20060101); B25B
23/00 (20060101); B25B 11/00 (20060101); B25B
23/14 (20060101); A61B 017/00 () |
Field of
Search: |
;81/59.1,124.4,124.5,125.1,467,473,478,474 ;267/287,309,328
;128/1R,33R |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
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732738 |
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Feb 1943 |
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DE2 |
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1168040 |
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Apr 1964 |
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DE |
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2538741 |
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Dec 1982 |
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FR |
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735393 |
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Mar 1978 |
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SU |
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856782 |
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Mar 1979 |
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SU |
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2148767 |
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Jun 1985 |
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GB |
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Other References
"CUSA.TM. Instruction Sheet," P/N 243 705 000 284, available from
Cooper LaserSonics, Inc..
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Primary Examiner: Coven; Edward M.
Assistant Examiner: Citrin; Randy
Attorney, Agent or Firm: Vorys, Sater, Seymour &
Pease
Parent Case Text
CROSS-REFERENCE TO RELATED APPLICATIONS
This application is a continuation of copending application, Ser.
No. 782,306, filed Oct. 1, 1985, now abandoned, which is
continuation-in-part of copending application, Ser. No. 761,495,
filed Aug. 1, 1985, now abandoned.
Claims
What is claimed is:
1. A method for assembling interchangeable acoustic members to a
surgical handpiece, said method comprising the steps of providing a
handpiece fixture having a body defining a handpiece receiving
opening therethrough for rotatably securing said handpiece against
rotation during torquing; hand tightening a selected acoustic
member to a transducer on said handpiece; selecting a socket having
a bore therethrough for mating with said acoustic member; placing
said selected socket on said acoustical member by sliding said
socket over and along a length of said acoustic member through said
bore; sliding a torque wrench over and along a length of said
acoustic member to engage said socket; rotating said wrench in a
first tightening direction about said socket to tighten the
acoustic member to a predetermined torque; and removing said wrench
and said socket from said acoustic member.
2. The method as set forth in claim 1, wherein the step of
tightening by rotating said wrench is accomplished while holding
said fixture in the hand of a user.
3. The method as set forth in claim 1, wherein the step of
tightening is accomplished further including the step of supporting
said handpiece fixture on a table support device.
4. A method for assembling and/or disassembling an acoustic member
to a surgical handpiece, said method comprising:
securing the handpiece against rotation during torquing in a
handpiece-receiving opening of a handpiece fixture,
hand tightening the acoustic member to the handpiece,
placing a socket, which has a bore therethrough which mates with
the acoustic member, on the acoustic member by sliding the socket
through the bore thereof along a length of the acoustic member,
sliding a torque wrench over and along a length of the acoustic
member to engage the socket, and
rotating the wrench in a tightening direction about the socket to
tighten the acoustic member to a predetermined torque.
5. The method of claim 4 including, thereafter, removing the wrench
and the socket from the acoustic member.
6. The method of claim 4 including,
before said hand tightening step, selecting the acoustic member
from among a plurality of interchangeable acoustic members for the
handpiece.
7. The method of claim 4 including,
said rotating step including the user holding the fixture in his
hand while rotating the wrench.
8. The method of claim 4 including,
said rotating step including the handpiece fixture being supported
on a table support.
9. The method of claim 4 including,
after said removing step, placing a socket having a bore
therethrough which mates with the acoustic member on the acoustic
member, sliding a torque wrench over the socket to engage the
socket in a loosening opening of the wrench, and rotating the
wrench in a loosening direction about the socket to loosen the
acoustic member.
10. The method of claim 9 including,
said loosening direction being opposite to said tightening
direction.
11. The method of claim 9 including,
said loosening opening being in the same torque wrench as said
tightening opening and spaced therefrom.
12. The method of claim 4 including,
said hand tightening step including hand tightening the acoustic
member to a transducer on the handpiece.
13. An apparatus for assembling and/or disassembling an acoustic
member, said apparatus comprising:
a surgical handpiece,
a fixture comprising a body member, said body member including a
defining means for defining a handpiece-receiving opening extending
transversely therethrough for receiving said surgical handpiece
therein, said body member including a securing means for securing
said surgical handpiece in position in said handpiece-receiving
opening, and
a torquing wrench means, including a first socket having a first
socket bore therethrough and which is open at both ends, which is
retained in scissor-like cooperating relationship with said fixture
for torquing an acoustic member to a predetermined torque value
into place on said surgical handpiece, after passing an end of the
acoustic member through said first socket bore, and while said
securing means secures said surgical handpiece against rotation in
and relative to said body member.
14. The apparatus of claim 13 including,
said body member including a body member outer surface, and
said body member defining a key slot communicating said body member
outer surface with said handpiece-receiving opening.
15. The system of claim 14 including,
said key slot forming at least a portion of said securing
means.
16. The apparatus of claim 13 including,
said body member having a first end and a second end, and
said body member including at said first end a first body portion
through which said handpiece-receiving opening passes, and an
elongated second body portion attached to said first body portion
and tapering so as to be thinner at said second end than at the
second body portion adjacent to said first body portion.
17. The apparatus of claim 13 including,
said handpiece-receiving opening having its periphery defined by
first, second, third and fourth arcs, said first and second arcs
being defined by a first center, said third arc being defined by a
second center spaced from said first center and said fourth arc
being defined by a third center spaced from said first and second
centers.
18. The apparatus of claim 17 including,
said second center being spaced horizontally from said first
center, and
said third center being at an upwardly-oblique angle from said
first center.
19. The apparatus of claim 13 including a support device comprising
a base plate; and a holding means for holding said fixture relative
to said base plate.
20. The apparatus of claim 19 including,
said fixture having a lower surface and defining a pin opening in
said lower surface, and
said holding means comprising a pin means for passing through said
base plate and engaging in said pin opening.
21. The apparatus of claim 19 including,
said support device comprising an upwardly-extending structure
secured to said base plate for receiving said fixture thereon.
22. The apparatus of claim 13 in which said torquing wrench means
includes a handle and a body connected to said handle, and
said body defines a first socket receiving opening means for
receiving said first socket therein and for engaging the acoustic
member and tightening the acoustic member on said handpiece, and a
second socket receiving opening which is open at both ends
thereof.
23. The apparatus of claim 22 including,
said torquing wrench means including a one-way roller clutch
bearing adjacent to said first socket receiving opening, and a
biasing means for biasing said clutch bearing to said predetermined
torque value, and
said biasing means including a roller contact means contacting said
clutch bearing, a spring means disposed in said handle for biasing
said roller contact means, and an adjusting means for adjusting the
compression of said spring means to determine said predetermined
torque value.
24. The apparatus of claim 23 including,
said roller contact means comprising a roller ball member.
25. The apparatus of claim 23 including,
said roller contact means comprising a roller member.
26. The apparatus of claim 25 including,
said spring means comprising a spring having a longitudinal spring
axis,
said roller member having a longitudinal roller axis, and
said roller axis being perpendicular to said spring axis.
27. The apparatus of claim 22 including,
said torquing wrench means including a second socket having a
second socket bore therethrough and which is open at both ends,
said body defining a second socket receiving opening for receiving
said second socket therein, and
said second socket receiving opening being open at both ends and
spaced from said first socket receiving opening.
28. An apparatus for assembling and/or disassembling an elongated
surgical acoustic member, said apparatus comprising:
a surgical handpiece,
a fixture comprising a body member, said body member including a
defining means for defining a handpiece-receiving opening extending
transversely therethrough for receiving said surgical handpiece
therein, said body member including a securing means for securing
said surgical handpiece in position in said handpiece-receiving
opening,
a torquing wrench means, which includes a first socket having a
first socket bore therethrough and which is open at both ends, for
torquing an elongated surgical acoustic member to a predetermined
torque value into place on said surgical handpiece, after an end of
the acoustic member has passed through said first socket bore, and
while said securing means is securing said surgical handpiece
against rotation in and relative to said body member, and
said first socket bore being structurally adapted to receive
therethrough and be axially slidable relative to the elongated
surgical acoustic member.
29. An apparatus for assembling and/or disassembling an acoustic
member, said apparatus comprising:
a surgical handpiece having a mating slot.
a fixture comprising a body member,
said body member including a defining means for defining a
handpiece-receiving opening extending transversely therethrough for
receiving therein said surgical handpiece,
said body member including a securing means for securing said
surgical handpiece in position in said handpiece-receiving
opening,
a torquing wrench means, which includes a first socket having a
first socket bore therethrough and which is open at both ends,
which is retained in scissor-like cooperating relationship with
said fixture for torquing an acoustic member to a predetermined
torque value into place on said surgical handpiece, after an end of
the acoustic member has passed through said first socket bore, and
while said securing means is securing said surgical handpiece
against rotation in and relative to said body member,
said body member including a body member outer surface,
said body member defining a key slot communicating said body member
outer surface with said handpiece-receiving opening, and
said securing means including a key means for engaging through said
key slot said mating slot of said handpiece for securing said
handpiece and said body member against relative rotation.
30. A surgical system comprising:
a surgical handpiece,
a fixture comprising a body member,
said body member including a defining means for defining a
handpiece-receiving opening extending transversely therethrough for
receiving said surgical handpiece therein,
said body member including a securing means for securing said
surgical handpiece in position in said handpiece-receiving
opening,
an acoustic member, and
a torquing wrench means, which includes a first socket having a
first socket bore therethrough and which is open at both ends, for
torquing said acoustic member to a predetermined torque value into
place on said surgical handpiece, after an end of said acoustic
member has passed through said first socket bore, and while said
securing means is securing said surgical handpiece against rotation
in and relative to said body member.
31. A torque wrench for assembling or disassembling an acoustic
member to or from a surgical handpiece, said torque wrench
comprising:
a head member,
an elongated handle having a longitudinal axis, a distal end and a
proximal end, and being secured at said distal end to said head
member,
a first socket having a first socket bore passing therethrough and
which is open at both ends,
said head member defining a first socket receiving opening, which
is open at both ends, and in which said first socket is
received,
a clutch means including a one-way roller clutch bearing adjacent
to said first socket receiving opening and a biasing means for
biasing said clutch bearing to a predetermined torque,
said biasing means including a roller contact means contacting said
one-way roller clutch bearing, a spring means disposed in said
handle for biasing said roller contact means, and an adjusting
means for adjusting the compression of said spring means to
determine said predetermined torque,
said spring means extending along the longitudinal axis of said
elongated handle,
said adjusting means including an adjustment screw at said proximal
end of said handle and operatively engageable with said spring
means.
32. The wrench of claim 31 including,
a second socket having a second socket bore passing therethrough
and which is open at both ends, and
said head member defining a second socket receiving opening spaced
from said first socket receiving opening which is open at both ends
for receiving said second socket therein.
33. The wrench of claim 32 including,
said first socket receiving opening being axially longer than said
second socket receiving opening.
34. The wrench of claim 31 including,
said roller contact means comprising a roller ball member.
35. The wrench of claim 31 including,
said roller contact member comprising a roller member.
36. The wrench of claim 35 including,
said spring means comprising a spring having a longitudinal spring
axis,
said roller member having a longitudinal roller axis, and
said roller axis being perpendicular to said spring axis.
37. The wrench of claim 31 including,
said roller contact means comprising a first roller ball contacting
said clutch bearing and a second roller ball contacting said first
roller ball and said spring means.
38. The wrench of claim 31 including,
said handle having a handle longitudinal axis,
said head member having upper and lower surfaces which said first
socket receiving opening engages at opposite ends thereof, and
said handle longitudinal axis passing between said upper and lower
surfaces.
39. The wrench of claim 31 adapted to receive a curved extender
having a curved profile and positionable in said first socket
bore,
said first socket being an extender socket, and
said first socket bore being laterally extended to define a slot to
accommodate therethrough said curved surface of said curved
extender.
40. The wrench of claim 31 in which,
said one-way clutch bearing including means for preventing a
loosening operation when said elongated handle is rotated in a
counter-clockwise direction.
41. The wrench of claim 31 including,
said head member having a stepped shape.
42. The wrench of claim 31 including,
said one-way roller clutch bearing including a cam member, and said
spring means pressing said roller contact means in contact with
said cam member.
43. The wrench of claim 31 including,
said head member having a head member top and a head member
side,
said handle being fixedly secured to said head member side, and
said first socket bore engaging said head member top.
44. An assembly comprising:
(1) a fixture which has a means for defining a handpiece-receiving
opening therethrough for securing a surgical handpiece therein
against rotation during a torquing procedure, and a bottom surface
opening; and
(2) a support device associated with said fixture, said support
device comprising:
a base plate,
an upwardly-extending structure secured to said base plate and
having a configuration for receiving said fixture thereon in an at
least partially holding manner,
a pin passing up through said base plate inside of said
upwardly-extending structure and adapted to extend into said bottom
surface opening of said fixture when said fixture is positioned in
said upwardly-extending structure, and
at least one fixture support-engageable foot pad connected to and
positioned beneath said base plate.
45. A fixture for securing a surgical handpiece against rotation
during a torquing procedure, said fixture comprising:
a first body member defining a handpiece-receiving opening
extending transversely therethrough and structurally adapted for
receiving a surgical handpiece therein,
said first body member including a body member outer surface and a
securing means for securing in said handpiece-receiving opening the
surgical handpiece against rotation during a torquing
procedure,
said securing means including said first body member defining a key
slot communicating said body member outer surface with said
handpiece-receiving opening, and
an elongated second body member attached to and tapering away from
said first body member.
46. The fixture of claim 45 including,
a body member securing means for securing said second body member
to said first body member.
47. The fixture of claim 46 including,
said body member securing means comprising at least one bolt.
48. The fixture of claim 46 including,
said body member securing means passing up through an opening in a
lower surface of said first body member.
49. The fixture of claim 45 including,
said second body member having a notch in an upper corner thereof
and said first body member fitting into said notch and being
attached thereto.
50. The fixture of claim 45 including,
said first body member being formed of a first material, and
said second body member being formed of a second material different
than said first material.
51. The fixture of claim 45 including,
said handpiece-receiving opening having its periphery defined by
first, second, third and fourth arcs, said first and second arcs
being defined by a first center, said third arc being defined by a
second center spaced from said first center, and said fourth arc
being defined by a third center spaced from said first and second
centers.
52. The fixture of claim 51 including,
said second center being spaced horizontally from said first
center, and
said third center being at an upwardly-oblique angle from said
first center.
53. The fixture of claim 45 including,
said second body member defining a lower surface, a left end
surface, and a sloped upper surface which merges into said left end
surface,
said first body member defining a right end surface having a height
greater than the height of said left end surface, and a horizontal
upper surface merging into said right end surface, and
said surfaces being proportioned to be held conveniently in the
hand of the user.
54. A fixture for securing a surgical handpiece having a mating
slot against rotation during a torquing procedure, said fixture
comprising:
a first body member defining a handpiece-receiving opening
extending transversely therethrough and structurally adapted for
receiving a surgical handpiece having a mating slot therein,
said first body member including a body member outer surface and a
securing means for securing in said handpiece-receiving opening the
surgical handpiece against rotation during a torquing
procedure,
said securing means including said first body member defining a key
slot communicating said body member outer surface with said
handpiece-receiving opening,
a second body member attached to said first body member, and
said securing means including a key means for engaging through said
key slot the mating slot of the handpiece for securing said first
body member and the surgical handpiece against relative
rotation.
55. A fixture for securing a surgical handpiece against rotation
during a torquing procedure, said fixture comprising:
a first body member defining a handpiece-receiving opening
extending transversely therethrough and structurally adapted for
receiving a surgical handpiece therein,
said first body member including a body member outer surface and a
securing means for securing in said handpiece-receiving opening the
surgical handpiece against rotation during a torquing
procedure,
said securing means including said first body member defining a key
slot communicating said body member outer surface with said
handpiece-receiving opening,
a second body member attached to said first body member and having
a notch in an upper corner thereof, and
said first body member fitting into said notch and being attached
thereto.
56. A fixture for securing a surgical handpiece against rotation
during a torquing procedure, said fixture comprising:
a first body member defining a handpiece-receiving opening
extending transversely therethrough and structurally adapted for
receiving a surgical handpiece therein,
said body member including a body member outer surface and a
securing means for securing in said handpiece-receiving opening the
surgical handpiece against rotation during a torquing
procedure,
said securing means including said body member defining a key slot
communicating said body member outer surface with said
handpiece-receiving opening,
a second body member attached to said first body member, and
said handpiece-receiving opening having its periphery defined by
first, second, third and fourth arcs, said first and second arcs
being defined by a first center, said third arc being defined by a
second center spaced from said first center, and said fourth arc
being defined by a third center spaced from said first and second
centers.
57. The fixture of claim 56 including,
said second center being spaced horizontally from said first
center, and
said third center being at an upwardly-oblique angle from said
first center.
58. A fixture for securing a surgical handpiece against rotation
during a torquing procedure, said fixture comprising:
a first body member defining a handpiece-receiving opening
extending transversely therethrough and structurally adapted for
receiving a surgical handpiece therein,
said body member including a body member outer surface and a
securing means for securing in said handpiece-receiving opening the
surgical handpiece against rotation during a torquing
procedure,
said securing means including said body member defining a key slot
communicating said body member outer surface with said
handpiece-receiving opening,
a second body member attached to said first body member,
said second body member defining a lower surface, a left end
surface, and a sloped upper surface which merges into said left end
surface,
said first body member defining a right end surface having a height
greater than the height of said left end surface, and a horizontal
upper surface merging into said right end surface, and
said surfaces being proportioned to be held conveniently in the
hand of the user.
59. An apparatus for assembling and/or disassembling an acoustic
member to and/or from a surgical handpiece, said apparatus
comprising:
a body member including a defining means for defining a
handpiece-receiving opening extending transversely therethrough for
receiving a surgical handpiece therein,
said body member including a securing means for securing the
surgical handpiece in position in said handpiece-receiving
opening,
said body member having a first end and a second end, and
said body member further including at said first end a first body
portion through which said handpiece-receiving opening passes, and
an elongated second body portion attached and adjacent to said
first body portion and tapering so as to be thinner at said second
end than at said second body portion adjacent to said first body
portion.
60. An apparatus for assembling or disassembling an acoustic member
to or from a surgical handpiece, said apparatus comprising:
a body member including a defining means for defining a
handpiece-receiving opening extending transversely therethrough for
receiving a surgical handpiece therein,
said body member including a securing means for securing the
surgical handpiece in position in said handpiece-receiving opening,
and
said handpiece-receiving opening having a periphery which is
defined by four successively contiguous arcs consisting of a first
and third arc bracketing a common first center point; a second arc
contiguous with the first and third arcs and having a second center
point spaced from the first center point of said first and third
arcs; and a fourth arc contiguous with the third and first arcs but
having a third center point spaced from the first and second center
points.
61. The apparatus of claim 60 including,
said second center being spaced horizontally from said first
center, and
said third center being at an upwardly-oblique angle from said
first center.
Description
BACKGROUND OF THE INVENTION
This invention relates to an apparatus and method for an assembly
and a disassembly of interchangeable surgical acoustic members.
More particularly, this invention relates to a fixture for securing
a surgical handpiece for cooperating with a torquing wrench having
a tightening head with predetermined torquing limits and a
loosening head mounted on the same body. Still more particularly,
this invention relates to a method of assembling and disassembling
such interchangeable surgical acoustical members.
Ultrasonic surgical devices are known for performing a number of
surgical procedures. A representative device is shown in U.S. Pat.
No. 3,589,363 describing a hand-held instrument having an operative
tip vibrating at a frequency in the ultrasonic range, and in which
a handpiece includes a transducer. Connections are provided on the
handpiece to a source of treatment fluid and a pump to withdraw
suspended tissue particles in a fluid from an operative site. The
tip is elongated and provided with a thickened shank portion formed
with a pair of flats, originally intended to accommodate a wrench
for tightening.
In practice, the design of such ultrasonic surgical devices depends
not only on the technical and functional requirements of a resonant
body, but also upon its surgical application. Thus, the length of
the tip and its diameter to be acceptable for a useful surgical
device in various operative site areas has developed over the
years, based upon experience with such devices. In particular, it
has been determined in the art that an especially useful
arrangement incorporating proportioned surgical acoustic members,
both from the standpoint of its surgical application and with
respect to its manufacturability and costs, is based upon a
combination of parts that are threaded together for easy
interchange. The joint between the tip and the device is generally
made at a point between a half-wave and quarter-wave length of the
acoustic member in question.
However, as the length of the interchangeable part approaches a
quarter wavelength, the stress at the threaded joint increases,
thus requiring a greater force to maintain the coupling surfaces in
appropriate contact during ultrasonic vibrations. In practice, it
is important for intimate contact to be maintained between the
coupling surfaces to maximize energy transfer, minimize mechanical
losses, obtain consistent performance during surgical use of the
device, and to minimize parasitic vibrations during operation. In
particular, the latter may cause premature failure of either or
both of the coupled acoustic members.
Experience with such devices has also determined an appropriate
coupling force or torque for such systems. The coupling torque is
sufficiently great that the acoustic members cannot be adequately
fastened with normal finger force, requiring a wrench with an
appropriate mechanical advantage. Thus, a technique for fastening
and unfastening such surgical tips to such devices has been
available to the art, as will be described in greater detail.
The techniques of fastening and unfastening the surgical tip to the
device are based upon a number of constraints in the art. On the
one hand, the design and size of the threaded joint between the tip
and the acoustical member is made as small as possible to minimize
the weight for the surgeon and to minimize visual interference with
the surgical procedure. Partly because of such size, overtightening
of the threaded joint is not desirable since overtightening may
overstress the threaded joint resulting in its fracture. On the
contrary, insufficient tightening can result in incomplete
acoustical coupling, heating of the threaded joint, degraded
surgical performance, and a potential for eventual catastrophic
failure of the acoustic parts.
A system available to the art, which will be described in
connection with FIGS. 1 and 2, has provided two torque wrenches, a
tip socket, a stack socket and a holding fixture to provide
operating room personnel with an ability to secure the handpiece of
the surgical device, tighten the tip to the handpiece to a preset
level, and then later untighten the interchangeable acoustic
members used for each surgical case. Such an apparatus used a
conventional tightening wrench, but some difficulty was experienced
in providing enough force to loosen the ultrasonic tip after a
surgical usage. Accordingly, a second wrench, for untightening, was
provided as an adapted commercial device allowing disassembly of
the acoustic members without allowing uncontrolled tightening by
the use of a single direction clutch. Such an apparatus was
intended for use in a non-sterile field and somewhat cumbersome as
surgical devices developed to include curved and straight
extenders. The availability of alternative tip structures for use
by the surgeon resulted in a more elaborate and more complex device
which is difficult and confusing to utilize, was not easily
portable, and tended to be expensive to manufacture. In addition,
such device was not readily sterilizable for use in an operative
field for the convenience of changing tips during surgery.
Accordingly, it was a problem in the use of such a device to
develop a simplified torque wrench to combine the tightening and
loosening features in a single wrench, capable in this environment
of cooperating with an existing handpiece holding fixture. One
particular problem was that socket wrenches which were commercially
available were not readily useable on elongated members because the
available sockets are solid and not suited for use at a position
intermediate an elongated member.
Accordingly, it is an overall object of this invention to provide a
modified fixture for securing the handpiece of the surgical device
for tightening and loosening a surgical tip secured to the
handpiece.
It is another overall object of the invention to provide such a
handpiece fixture which can be hand-held or readily mounted on a
stand on a table to support the handpiece and handpiece fixture
during assembly or disassembly.
It is still another object of the invention to provide such a
handpiece fixture which is capable of accepting in a rotatably
secure position various handpiece and tip combinations, such as are
comprised by a standard straight handpiece or an angled handpiece,
on the one hand, connected directly to straight, curved or flexible
tips, or to straight or curved extenders to which the tip is
attached.
It is still another object of the invention to provide such a
fixture for a handpiece of the type described, wherein the relative
rotation between the fixture, a handpiece, and the acoustic
vibrator can be secured to a key as in the currently commercial
embodiment so that the fixture and wrench according to this
invention can be utilized with existing surgical devices and
handpieces currently available to operating personnel.
It is another overall object of this invention to provide a
convenient method and apparatus to facilitate a change in the
fragmenting and related elements during a surgical procedure in a
way which eliminates a need for removing the acoustic vibrator from
the handpiece as in the prior art.
It is still another overall object of this invention to provide a
torque wrench which is capable of sliding over an assembled and
hand-tightened combination of a handpiece, tip, and/or extender and
to provide a socket which is structurally accommodated to such an
elongated subassembly.
It is still another object of this invention to provide a torque
wrench with a socket assembly of the type described having both a
tightening head preset to a predetermined torquing limit and a
loosening head, arranged in such a way to preclude an operator from
applying the wrench in an erroneous direction.
It is still another object of this invention to provide a fixture
for use with such a wrench that can be used in hand to cooperate
with the wrench in a scissor fashion, or be supported on a table
support plate at the choice of the user.
It is a further overall object of this invention to provide such a
handpiece torquing set in kit form for the convenience of medical
personnel and arranged for easy sterilization within the sterile
field so that the tips can be quickly and easily exchanged either
prior to, during or after surgery with a minimum disassembly of the
handpiece, while avoiding inadvertent damage to the exposed
acoustic vibrator stack and human engineered to minimize operator
error and confusion.
BRIEF SUMMARY OF THE INVENTION
Directed to achieving the foregoing objects of the invention and
overcoming problems in connection with the tightening and loosening
of an acoustic vibratory assembly having a transducer and a tip to
a handpiece in a surgical device, the invention comprises a
handpiece fixture for use in combination with a torquing wrench
having a tightening head and a loosening head disposed in a common
body for receiving a socket therein for engaging mating tool pads
on a surgical tip to tighten the tip to form an acoustic vibrator
tightened to a predetermined tightening tolerance.
The fixture includes a body, having a base surface and a thickness
capable of being held in the hand of a user. A top surface includes
an inclined portion merging into a top end surface defining an
elongated keyway for receiving a key therein to secure a hand
tightened preassembly of a handpiece acoustic vibrator in an
elongated transverse opening passing through the body from the
opposed side surfaces of the fixture. The opening is significantly
defined in cross section by a circle having its radius at the
center of an opening, portions of which merge with the segments of
a circle having a second radius centered on an axis horizontally
remote from the main axis of the opening and a second circle
centered on an axis oblique to the main axis. Thus, the opening is
defined by four connected arcuate surfaces to accommodate and
secure various types of handpieces (straight or angled) in
combination with various tips (straight or angled) in combination,
when used, with various extenders (straight or angled). Preferably,
the body is made of a suitable rigid plastic material and the
transverse opening is defined in a block made from metal or other
material of sufficient mechanical strength, and secured in an upper
foremost location of the body by threaded fasteners. The lower
surface of the fixture defines a plurality of openings for mating
with extending pins on the upper surface of a table support device.
The table support device includes a base plate which comprises a
rectangular body to which are secured a plurality of table-engaging
foot pads. Mediately disposed on the upper surface of the body is
an upwardly-extending elongated support plate from which the
fixture engaging pins extend, and further defining a transverse
channel in the upper surface thereof.
The handpiece fixture is thus held by hand or mounted to a table
support device positioned on a table to support the handpiece and
the fixture during assembly or disassembly. When used by hand, the
torquing wrench is positioned so that the handpiece fixture and
wrench are used in a scissor-like fashion. When the operator uses
the table support device, the wrench is positioned so that it may
be pushed downwardly while holding the handpiece fixture against
the table with the opposite hand of the operator. The transverse
channel in the upwardly extending elongated support plate of the
table support device is used during the disassembly of the tip from
the extender.
The method of using the fixture and the wrench according to the
invention includes the step of providing a handpiece fixture of the
type described, hand-tightening a selected tip and/or extender to a
transducer, selecting a socket having a bore therethrough for
mating with the tip or extender, placing the socket on the tip or
extender, sliding the torque wrench over the socket to engage the
socket, rotating the wrench in a first tightening direction about
the socket to tighten the tip or extender to a set predetermined
torque. It is a feature of the socket and wrench that they may be
axially slid over the axially elongated hand tightened subassembly
of the transducer tip and/or extender.
In an alternative method of use, the handpiece fixture is
positioned on the table support device so that the openings in the
base portion thereof engage the pins extending from the table
support plate, and the hand-tightened subassembly is secured by a
key in the transversely extending opening in the handpiece fixture.
A socket is slid over the subassembly, the wrench engages the
socket, and the tip and/or extender is tightened with the torquing
wrench.
After use, or to change a tip and/or extender, the untightening
head of the torque wrench is used in conjunction with the handpiece
fixture and/or the transverse slot in the table support device.
As described, the apparatus and method provides the user with a
significantly simplified and enhanced capability to quickly and
easily exchange a variety of tips either prior to, during, or after
surgery, while requiring a minimum disassembly of the handpiece to
facilitate quick attachment and removal.
BRIEF DESCRIPTION OF THE DRAWINGS
In the drawings:
FIG. 1 provides a basis for understanding a prior art method and
apparatus for interchanging surgical acoustic members, wherein:
FIG. 1(a) depicts the attachment of a tip to a transducer, with or
without an extender;
FIG. 1(b) shows the use of a stack socket to prepare the
subassembly for tightening;
FIG. 1(c) shows the manner of securing the stack
socket-tip-transducer subassembly for tightening;
FIG. 1(d) shows the tightening operation with the use of a tip
socket;
FIGS. 1(e) and 1(f) show the attachment of the nose cone
assembly;
FIGS. 1(g) and 1(h) show the attachment of the flue assembly;
FIGS. 1(i) and 1(j) show the attachment of the handpiece assembly
to the acoustic vibrator and nose cone with the flue; and
FIGS. 1(k) and 1 (l) show the completion of the assembly by
connecting the manifold assembly;
FIG. 2 is a depiction of a prior art kit containing both an
assembly wrench and disassembly wrench with a stack socket and a
tip socket for performing the operations of FIG. 1;
FIG. 3 is a perspective view, partly in section, of the handpiece
fixture according to the invention;
FIGS. 4(a) and 4(b) together show a top view and side view,
partially in section, of a torquing wrench according to the
invention;
FIG. 5 shows a tip socket wherein FIG. 5(a) is an end view: and
FIG. 5(b) is a side view thereof;
FIG. 6 illustrates an extender socket where FIG. 6(a) is an end
view and FIG. 6(b) is a side view of the extender socket;
FIG. 7 is a diagrammatic view of the cooperation of the fixture and
torquing wrench acting as a scissor, when the operator prefers to
hand hold the fixture;
FIG. 8 is a top diagrammatic view of a handpiece assembly secured
in the handpiece fixture with the torque wrench engaging an
exchangeable socket for exchanging the tip or other acoustical
member;
FIG. 9 is a view of the table support device wherein FIG. 9(a) is a
top view thereof and FIG. 9(b) is a side elevational view thereof
partially in section;
FIG. 10 is a side elevational view of the table support member of
FIG. 9, securing the fixture of FIG. 3, for use with the wrench of
FIG. 4; and
FIGS. 11(a) and 11(b) together show a top view and side view,
partially in section, of an alternative embodiment of the torquing
wrench of FIGS. 4(a) and 4(b).
The drawings are illustrative of the concept of the wrench to teach
the selected art and should not unduly limit the invention which
obviously could include other embodiments obvious to a person of
ordinary skill in the art within the spirit of the invention.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
In order to facilitate an understanding of the features and
advantages of the fixture and wrench according to the invention and
the method of assembly and disassembly which are features of the
foregoing invention, a description is provided of the prior art
method of assembly and disassembly as applied to an apparatus of
the type described in U.S. Pat. No. 3,589,363, for example, the
disclosure of which is incorporated by reference.
In FIG. 1, and more particularly in FIGS. 1(a)-1(h), a prior art
method of assembly of a surgical device, showing the steps of
assembling an acoustic vibrator, a nose cone assembly for the
acoustic vibrator, a flue assembly, a handpiece, and a manifold, is
described for both an assembly which includes only a tip, or with a
curved or straight extender interposed between the tip and a
transducer. Thus, as shown in FIG. 1(a), a tip 20 having a flange
21 with tool pads is hand tightened by threading into a mating
opening 22 of a transducer 23. The transducer has an elongated slot
24 for receiving a key. At the righthand portion of FIG. 1(a), a
similar assembly is shown in which an extender 26 is interposed
between the tip 20 and the transducer 23. In either case, the
subassembly is hand tightened to form an acoustic vibrator. As
shown in FIG. 1(b), when an extender 26 is used, the acoustic
vibrator is placed in a stack socket 27 having a keyway 28 and
secured by a key-chain 29 in a slot in the body of stack socket to
mate with the opening 24 in the transducer after alignment. As seen
in FIG. 1(c), a tip socket 30 is provided as part of a set, shown
diagrammatically in FIG. 2. As provided, the set includes the stack
socket 27, the tip socket 30, an assembly wrench 31, a disassembly
wrench 32, and a hold down plate 33 which is pivotable about pin 34
to secure the subassembly in openings or grooves in the torquing
set. As seen in FIG. 1(c), when only a tip is used, the acoustic
vibrator assembly is axially aligned, whereas if a curved extender
is used, the relationship between the grooves beneath the hold down
plate 33 and associated grooves in the set is such to accommodate
the angle subtended by the extender-transducer subassembly. In
either event, the hold down plate 33 is rotated to an open position
and the acoustic vibrator is positioned in the torquing kit in an
appropriate groove. When only a tip is used, a single key will mate
with the opening 24 in the transducer, whereas if an extender is
used, a pair of keys is used in vertically spaced slots to secure
the acoustic vibrator therein.
As shown in FIG. 1(d), the hold down plate 33 is pivoted to its
closed position, and the tip socket 30 is slid over the tip 20. An
assembly wrench 31 is attached to the tip socket and rotated until
a predetermined, preset torque is achieved according to the
construction of the assembly wrench, and the wrench 31 is removed.
The tightening wrench 31 is then attached to the stack socket 30
and rotated until a predetermined torque is achieved so that both
the extender and the tip have been tightened to the predetermined
torque.
After the acoustic vibrator is assembled as shown in FIGS.
1(a)-1(d), a nose cone is assembled as shown in FIGS. 1(e) and
1(f). A pair of O-rings 36 and 37 is provided adjacent a flange on
the transducer remote from the tip 20 and seated therein. A third
O-ring 38 is provided in a groove on the transducer 23 proximate to
the tip 20 and a nose cone 39 is axially slid and rotated to seat
the nose cone 39 to the acoustic vibrator by threaded
engagement.
Thereafter, as shown in FIGS. 1(g) and 1(h), a flue 40 secured to a
body 41 having a nose cone adapter 42 at one end thereof is slid
over the tip-extender combination. Where only the tip 20 is used,
only the flue 40 and nose cone adapter 42 are needed. The flue 40
is then aligned relative to the tip 20 to centralize the tip 20
within the flue 40.
Thereafter, the subassembly comprising the acoustic vibrator, the
nose cone, and the flue is inserted into a handpiece housing 42 and
rotated until snug, as shown in FIGS. 1(i) and 1(j). Thereafter, an
aspiration tube 44 with a flexible applicator cable 45 is inserted
through a slot in the nose cone 38 and fed through an aspiration
port 46 within the nose cone. By pulling the cable 45 through the
tip 20, the aspiration tube 44 will attach to the aspiration port
46. As shown in FIG. 1(l), the irrigation tube is secured to an
irrigation port 48, and clips 47 secure the tubing to the body of
the instrument. The irrigation and aspiration tubing is then
connected to the instrument.
To disassemble the acoustic vibrator after surgical procedure, the
above-described assembly instructions are reversed, using a
disassembly wrench 32.
An improved fixture according for use to the invention is shown in
FIG. 3 for securing the assembled handpiece acoustic members
therein to complete tightening. The fixture includes a body 50
defining a lower surface 51 having a pair of openings 52 therein.
The body 50 defines a sloped upper surface 53 merging into a left
end surface 54 and a generally horizontal upper surface 55 merging
into a right end surface 56 having a height greater than the height
of the surface 54. Such a structure, which resembles a staple gun,
is designed to be held conveniently in the hand of the user. The
upper surface 55 defines a key slot 57 merging into a transversely
extending opening 58 for receiving and securing the handpiece. The
structure of the transverse opening 58 is designed to receive a
straight handpiece, an angled handpiece, which is angled at any
angle up to ninety degrees, a straight extender, a curved extender,
or other handpiece assemblies. Thus, the opening 58 is defined by a
pair of arcs 59 and 60 about a center 61, a third arc 62a defined
about a center 62 located horizontally remote from the center axis
61 and an arc 64 located about a center 65 at an upwardly oblique
angle from the center axis 61. The handpiece which is axially
elongated and its tip (or tip/extender combination) are fixedly
secured by a key inserted into the key slot 57 to couple the
fixture with the handpiece to prevent relative rotation between the
fixture, handpiece and acoustic vibrator. The fixture according to
FIG. 3, in conjunction with the torque wrench of FIG. 4,
significantly enhances the ability of operating room personnel to
change fragmenting and related elements during the operating
procedure, thus eliminating the necessity of removing the acoustic
vibrator from the handpiece proper as had been required in
connection with the procedure described in connection with prior
art FIG. 1. The new fixture is intended to accept the assembled
handpiece.
FIG. 4 is a diagrammatical illustration of the torque wrench 70
constructed for use with the invention. The wrench 70 comprises a
housing or body 71 connected to a handle 72. The body defines a
first socket receiving opening 73 for tightening to a predetermined
torque and an adjacent socket receiving opening 74 for loosening a
tip or extender from the transducer. Preferably, the tightening
head of the wrench only tightens when the wrench is rotated in a
clockwise direction and incorporates a one-way clutch to prevent a
reverse (or loosening) operation. Conversely, the loosening head of
the wrench preferably only loosens when rotated in a
counterclockwise direction and likewise incorporates a one way
clutch operated in reverse to that associated with the tightening
action in order to prevent tightening and to minimize a possibility
of human error. The tightening head 73 includes a sleeve insert
receiver 76, a bearing plate 77 for retaining a clutch bearing 78,
and a retaining ring 79 to form an operative assembly, as is well
known in the art. The clutch bearing 78 is pressed into a cam
member 80 and the bearing plate 77 is positioned in the body 71.
The cam assembly is inserted into the body to mesh with the bearing
plate 77 and the handle 72 is added as a subassembly.
The handle 72 includes a lubricated member 82, (either a ball or
roller) a ball or slider 83, biased by a spring 84, and a spring
retaining member 85 to provide a preselected amount of torquing
according to positioning of the screw 86. Labels 87 and 87a bearing
suitable indicia are respectively secured on the tightening and
loosening heads 73 and 74 to indicate the direction of operation of
the wrench.
The loosening head 74 includes a sleeve insert member 88, a roller
clutch 90, and a bearing plate 92 to define the socket receiving
opening for tightening. It is a feature of this torquing wrench to
be able to mate with a socket which is axially slidable along the
elongated member, such as the transducer, tip, and extender, if
used.
While the individual elements of the wrench are known, for the
first time they are being used together in a novel combination for
applications in a surgical environment. The surgical and especially
the sterile surgical field present a set of unique technical
requirements in that:
(a) the device must be reasonably light and easy to use by a
non-technical person, such as a nurse;
(b) the wrench must be reasonably inexpensive so that, as an
accessory, its cost benefit ratio will be considered advantageous
to the customer and the producer; and
(c) the wrench must remain in calibration for long periods of time
or the proper function of the ultrasonic surgical device it
services will be impaired. Hospital personnel traditionally have no
way of checking the calibration of the device.
As shown in FIGS. 4(a) and 4(b), the design of the torque wrench
addresses requirement (a) in a number of ways to provide a number
of advantages.
First, the shape of the head is stepped and is thus human
engineered to require its application in the proper direction
only.
Second, the sleeves which accept the hex sockets are stepped to
prevent an improper insertion of the sockets.
Third, the head material is aluminum for light weight.
Fourth, the handle length is proportioned for proper balance and
yet easy mechanical advantage.
The design of the torque wrench in FIGS. 4(a) and 4(b) also
addresses the cost requirement.
An application of one way roller (clutch) bearings to a torque
wrench is a low cost, functionally effective application of a well
known art to a new field. One way ratchet devices which are usually
seen in this type of device are complex, expensive or unreliable.
The one way roller clutch is a simple, elegant solution to an old
problem and is especially suitable to the surgical environment in
question.
The design of the torque wrench in FIGS. 4(a) and 4(b) addresses
the requirement of calibration as follows:
The two element mechanism in the handle: comprising elements 82 and
83 of FIG. 4(a), provides a way to apply the spring force in an
appropriately constrained fashion so that the torque applied is
consistent and repeatable without recalibration for long periods of
time. Normal torque wrenches lose their calibration after hundreds
of cycles. This device is designed to operate for thousands of
cycles without recalibration.
Thus, the wrench of FIGS. 4(a) and 4(b) provides for an unlimited
angular rotation of the torquing device without fear of
overtightening. Moreover, it provides a device with a resettable
torque which allows a tightening of unlimited length members. These
features are in constrast to devices which do not feature open or
through sockets, ratchet wrenches which have a limited rotation, or
open end torque limiting wrenches in which, if the present angular
rotation were exceeded, the torque limitation would no longer be
available.
FIGS. 5 and 6 respectively show a tip socket 92 and an extender
socket 93 to be received in the tightening and loosening socket
receiving opening as described. Preferably, the sockets define a
bore 92a, 93a therethrough so that the sockets may also be slid
axially along any elongated member, such as the tip and extender of
this invention. Preferably, the bore 93a in the extender socket is
laterally extended to define a slot as shown in FIG. 6 so that the
curved surface of a curved extender can be readily accommodated.
The mating portion of the socket is for the wrench preferably
hexagonal. In use, the handpiece is secured to the handpiece
fixture as discussed above and the tip and/or extender is screwed
thereto in a finger tight fashion. An appropriate socket, such as a
tip socket 92 for a tip 20 or an extender socket 93 for an extender
26, is selected and axially slid over the tip 20 or transversely
placed over the extender 26 respectively to engage the tool pads on
the tip or extender. The torque wrench 70 is then slid over the
elongated tip/extender structure and engages the selected
socket.
FIG. 7 shows the use of the fixture 50 and the wrench 70 to perform
the operation as discussed above when the operator holds the
fixture 50 in hand. Thus, the cooperation between the fixture and
the wrench acts as a scissor to perform the assembly or disassembly
operation as described.
FIG. 8 shows a view in diagrammatic fashion of an angled handpiece
secured by a key assembly to the handpiece fixture 50 wherein the
tip or other acoustic member is engaged by an exchangeable socket
92 for rotation by the torque wrench 70, in summary of the
discussion above.
FIGS. 9a and 9b show a table support device for mounting the
fixture of FIG. 3 thereon when an operator wishes to utilize the
method and apparatus according to this invention in connection with
the table. The table support comprises a base plate 102 having a
plurality of table-engaging foot-pads 103 to which is secured an
upwardly-extending rectangular member 104 having a plurality of
upwardly extending pins 105 from the upper surface thereof. The
pins 105 engage the mating recesses 52 in the lower surface 51 of
the fixture shown in FIG. 3.
FIG. 10 is a diagrammatic illustration of the support member of
FIG. 9 and the fixture of FIG. 3 during use. The wrench is
positioned so it is pushed down while the operator holds the
fixture against the table with the other hand.
A significant advantage of the invention is that all parts of the
handpiece torquing set are capable of sterilization, such as by
ethylene oxide gas, so that the tips and other parts may be
interchanged during surgery in the sterile field. As in the case of
the prior art embodiment, the components of the system are
preferably provided in the form of a set which includes a handpiece
fixture, a table support plate, a torquing wrench, a plurality of
sockets, a key, and instructions in a convenient pack.
FIGS. 11(a) and 11(b) show an alternative embodiment of the
torquing wrench which is quite similar to the embodiment of FIGS.
4(a) and 4(b). In this alternative embodiment, the ball members 82
and 83 are replaced by a roller member 101 having its outermost
surface in line contact with the cam member 80. The roller member
101 is restrained against rotational movement by a pin 102 slidably
located in a pair of openings in an elongated tappet member 103.
Thus, the roller member is free to slide to the left and right as
shown in FIG. 11(a). The roller member 101 is in line contact with
the cam, rather than in point contact, as in the case of the ball
82 in FIG. 4(a). As in FIG. 4(a), the tappet member 102 is biased
by a spring 84. The advantages and operational features of the
wrench embodiment in FIG. 11(a) are thus the same as in the
embodiment of FIG. 4(a).
This invention may be embodied in other specific forms without
departing from its spirit or essential characteristics. The present
embodiments are, therefore, to be considered in all respects as
illustrative and not restrictive, the scope of the invention being
indicated by the claims rather than by the foregoing description,
and all changes which come within the meaning and range of the
equivalents of the claims are therefore intended to be embraced
therein.
* * * * *